KELLY ANNE MAMELSON MD
NPI 1265006589
Student in an Organized Health Care Education/Training Program in Lebanon, NH

Q: What is Kelly Mamelson's NPI number?

The NPI number for Kelly Mamelson is 1265006589. It was assigned to this individual provider in the NPPES registry on May 20, 2021.

Q: What is Kelly Mamelson's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Mamelson was last updated on April 1, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 20, 2021PECOS Enrolled

1 MEDICAL CENTER DR, LEBANON, NH 03756(603) 650-5000 Get Directions Write a Review

NPPES record last updated: April 1, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 1, 2025, May 20, 2021 (2 updates tracked since 2021).

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About Kelly Anne Mamelson Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY ANNE MAMELSON MD (NPI 1265006589) is an individual student in an organized health care education/training program in Lebanon, New Hampshire and active in the NPI registry since May 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1265006589

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameKELLY ANNE MAMELSONCredential: MD

Location Address1 MEDICAL CENTER DRLebanon, NH 03756-0001

Mailing Address1 Medical Center DrLebanon, NH 03756-0001 · (603) 650-5000

Phone(603) 650-5000

Sole ProprietorNo

Enumeration DateMay 20, 2021

Last NPPES UpdateApril 1, 20252 updates tracked since enumeration

NPPES CertifiedApril 1, 2025

✔ NPI 1265006589 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedObstetrics & GynecologyTaxonomy 207V00000X · License 32855 (FL)

1 MEDICAL CENTER DR, Lebanon, NH 03756

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Anne Mamelson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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